Presentation on theme: "Headache Services in Wales in Neurology and other disciplines Dr Peter Brooks Eglwysbach Medical Practice, Pontypridd & Cardiff Headache Clinic Department."— Presentation transcript:
Headache Services in Wales in Neurology and other disciplines Dr Peter Brooks Eglwysbach Medical Practice, Pontypridd & Cardiff Headache Clinic Department of Neurosciences, University Hospital of Wales, Cardiff
HEALTH POLICY IN WALES Devolved since 1999 High illness prevalence Left of centre health policy Small private sector Low use of private sector by government No internal market Greater emphasis on public health Less demanding waiting list targets No ring-fencing of health budget
Neurology provision WTE consultant neurologists working from Swansea 8 WTE consultant neurologists working from Cardiff 4.5 WTE consultant neurologists working from Newport 3 WTE consultant neurologists working in North Wales, based at the Walton centre, Liverpool
Neurology provision in Wales Neuroscience centres at Cardiff and Swansea Academics – 2 professors, 2 senior lecturers Population ~ 3,000,000 ~ 22.5 WTE consultant neurologists 1 consultant neurologist per 133,000 European average 1:40,000
Referrals to Neurology Audit one month 2010 Cardiff and Vale LHB – 156 referrals 47% headache, 53% non-headache Other LHB areas – estimate >30% headache
Headache Service 1 regional dedicated headache clinic serving South East Wales (Cardiff and Vale, Cwm Taf and Aneurin Bevan LHBs) with capacity to see approximately 190 new patients per year and 85 follow-up appointments. Established 1999 with 1 consultant and 1 Hospital Practitioner (GP) 1 session per week Manpower in 2011 – 1 Hospital Practitioner with nominal consultant supervision (without headache interest); no specialist nurse; no dedicated inpatient beds.
Headache clinics No other dedicated headache clinics in Wales 2 consultants with an interest but with other responsibilities and a personal or institutional reluctance to develop a headache label
Cardiff Headache Clinic Limitations GON injection via pain clinic only Flunarizine available Botox not on formulary and not likely to be funded No neurosurgical specialist support No stimulator / neurosurgical treatments available for primary headache Not a consultant led service
The future of Neurology provision? 1 new consultant neurologist planned for Hywel Dda LHB 1 additional consultant neurologist planned for Cwm Taf Establish a centre for neurology in North Wales Aim for 1 consultant neurologist per 80,000
The Future of Headache Services in Wales – barriers and considerations Headache seen as low priority and uninteresting - I hate seeing headache patients – Dr Consultant Neurologist Neuroscience implementation programme 2009 – not a single mention of headache, despite…….! Moratorium on all new appointments in some LHBs.
The Future of Headache Services in Wales Persuade planners of needs of headache patients Tentative talks in LHB areas to develop a headache clinic ? Development of intermediate care services Prioritise attraction of a headache- interested consultant to develop regional headache services.
Dyfal donc a dyr y garreg – Persistent knocking breaks the stone A fo ben bid bont - He who would be head, let him be a bridge Po callaf y dyn, anamlaf ei eiriau – The wiser the man, the fewer his words The Future of Headache Services in Wales